The proposed research is designed to examine in what ways the return to work of persons with a chronic health condition may be influenced by barriers at the workplace, conceptions about the meaning of work, and a changing perspective on life that is a reflection more of social than chronological age. We hypothesize that three sets of non-medical variables are more important than medical or background characteristics in explaining resumption of work. These non-medical variables are: social conditions at the workplace; orientation toward work; and extent to which secondary gains of the sick role overweigh perceived benefits of going back to work. The relationship between aging, chronic illness and work will be tested by these hypotheses: 1. younger patients will be more likely than older ones to use the sick role as legitimation for the non-return to work; 2. younger patients will have adopted a time-yet-to-live perspective more characteristic of the middle and later years of life. The subjects will be men and women with end stage renal disease, 25-59 years of age (N=240), who were regularly employed in the year prior to beginning dialysis and who have no condition that specifically precludes working. A longitudinal design provides for a first interview with each patient about 3 months after treatment has begun and a follow-up one 6 to 9 months later. All subjects will be ambulatory patients and the analysis will control for type of maintenance therapy and organ transplant, if obtained. Thirty informant interviews are to be conducted with employers, not in firms where subjects may have worked but in the major types of work settings represented by subjects' jobs, in order to identify the factors that lead employers to be supportive, ambivalent, or negative about employing a person with end stage renal disease. In sum, the proposed research will identify the interrelationship among values, aging and the work role as they intervene between health and effective functioning.